Arthritis after Rotator Cuff Tear
A type of shoulder arthritis that develops after long-term rotator cuff damage or tendon rupture
Cuff tear arthropathy is a form of shoulder arthritis that can develop when a long-standing rotator cuff tear goes untreated or is too severe to heal on its own. Over time, the absence of a functioning rotator cuff leads to abnormal joint movement, resulting in wear and tear of the shoulder joint. This condition can cause significant pain, weakness, and loss of shoulder function.
What Causes Cuff Tear Arthropathy?
The rotator cuff is a group of muscles and tendons that stabilise your shoulder and allow smooth, controlled movement. If one or more of these tendons are torn and remain untreated—particularly in large or chronic tears—the shoulder may lose stability. This can cause the ball of the shoulder joint (humeral head) to shift out of its ideal position, leading to cartilage damage and joint degeneration.
Common contributing factors include:
A large or irreparable rotator cuff tear
Long-standing shoulder dysfunction
Repeated shoulder dislocations or subluxations
Age-related tendon degeneration
Symptoms of Cuff Tear Athropathy
Symptoms may develop gradually and can include:
A dull or aching pain in the shoulder, often worsening at night
Weakness in the arm and difficulty lifting or rotating the shoulder
A sensation of grinding or catching during movement
Reduced range of motion and shoulder stiffness
Difficulty performing everyday tasks such as dressing, lifting, or reaching overhead
How is Cuff Tear Arthropathy Diagnosed?
Diagnosis involves a combination of:
- Ageing: Cartilage naturally deteriorates with age, increasing the likelihood of arthritis.
- Previous Injuries: Shoulder injuries, such as fractures or dislocations, can increase the risk of developing arthritis.
- Repetitive Strain: Overuse or repetitive movements in sports or occupations can accelerate joint wear.
- Rheumatoid Arthritis: This autoimmune condition can cause inflammation and joint damage, including in the shoulder.
- Genetics: A family history of arthritis may increase susceptibility.
- Obesity: Excess weight can contribute to joint stress and inflammation, worsening arthritis symptoms.
Understanding these risk factors can help in early diagnosis and preventive strategies.
Treatment Options for Cuff Tear Arthropathy
Treatment depends on the severity of symptoms, your functional goals, and overall shoulder health. Dr McGrath will tailor a management plan to your needs.
Non-surgical treatment may include:
Activity modification
Physiotherapy to improve range of motion and compensate with surrounding muscles
Anti-inflammatory medications or corticosteroid injections for temporary pain relief
Surgical treatment:
For patients with advanced cuff tear arthropathy who do not gain sufficient relief from non-operative measures, surgery may be recommended.
Reverse total shoulder replacement is often considered the most reliable surgical option. This procedure changes the mechanics of the shoulder to rely on the deltoid muscle instead of the damaged rotator cuff, helping restore function and reduce pain.
When to See Dr Ben McGrath for Cuff Tear Arthropathy
If you’ve had a previous rotator cuff injury and are experiencing increasing shoulder pain, weakness, or functional decline, it’s important to have your shoulder assessed. Early intervention can help you avoid further joint deterioration and improve long-term outcomes.
Dr Ben McGrath has extensive experience managing both rotator cuff tears and cuff tear arthropathy. During your consultation, he will provide a clear diagnosis and discuss the most appropriate treatment options to help restore your shoulder function and quality of life.
Surgical Treatments for Shoulder Arthritis
For severe shoulder arthritis, surgery may be necessary to restore function and alleviate pain. Options include:
- Arthroscopy: A minimally invasive procedure to remove loose cartilage fragments or repair damaged tissues.
- Shoulder Replacement (Arthroplasty): In advanced cases, the damaged joint may be replaced with an artificial implant. Options include partial or total shoulder replacement, depending on the extent of the damage.
- Resection Arthroplasty: For arthritis affecting the acromioclavicular joint, part of the collarbone may be removed to relieve pain.
Dr McGrath discusses surgical options carefully, considering factors like age, activity level, and overall health. Rehabilitation is essential after surgery for optimal recovery.
When to See Dr Ben McGrath for Shoulder Pain
If shoulder pain or stiffness persists despite non-surgical treatments, or if symptoms significantly impact daily activities, a consultation with Dr McGrath can help explore advanced treatment options and develop a personalised care plan.
FAQs About Cuff Tear Arthropaty
Small rotator cuff tears may improve with rest, physiotherapy, and strengthening exercises. However, large or chronic tears are less likely to heal on their own and may lead to progressive shoulder damage over time. If left untreated, they can result in cuff tear arthropathy.
Cuff tear arthropathy is a specific type of arthritis that occurs after a severe or long-standing rotator cuff tear. Unlike age-related wear-and-tear arthritis (osteoarthritis), this condition develops due to the loss of shoulder stability and altered joint mechanics from a torn rotator cuff.
For patients with ongoing pain and loss of function despite non-surgical management, reverse total shoulder replacement is often the most effective surgical option. It can improve pain, restore mobility, and allow patients to return to many daily activities. Dr McGrath will discuss whether this option is appropriate for your situation.